Adolesan İdiopatik Skolyoz Tanısıyla İzlenilen Asemptomatik Hastalarda Femorasetabular Sıkışmanın Morfolojik Spekturumu
Özet
Femoroacetabular impingement is a newly defined painful hip pathology that affects adolescent and young adults. The pain is due to mechanical impingement between the femoral head-neck junction and the acetabular rim during hip movement, especially in flexion and internal rotation . This abnormal and recurring impingement results in destruction of the labrum and cartilage, which is thought to result in osteoarthritis of the hip in untreated patiens. In the current literature,it seems that early surgical treatment of this mechanical problem stops or delays the advancement of this hip disease. The purpose of this current double-cohort study was to address the following questions: (1) What is the prevalence of radiographic abnormal femoroacetabular impingement morphology in adolescents with no hip joint symptoms? (2) Is there any meaningful difference in the prevalence or characteristics of these parameters between the group with scoliosis, comparedwith a group without scoliosis with asymptomatic hips?(3)Is there any meaningful differences between spinopelvic and FAİ parameters? We found a hıgh prevalence of radiographic abnormalities in patients who were asymptomatic.We also found significant differences in the rates of certain radiographic parameters between patients with and without scoliosis.In our study we also found a wide array of values for the radiographic parameters we studied.These can be meaningfully used to recategorize normative data for the adolescent population group.We found no statistically meaningful differences between spinopelvic and FAİ morphology without sacral slop .As noted in our study,there is a high prevalence of radiographic impingement morphology beyond the spectrum of what is currently defined as normal in adolescents with no hip-related symptoms. On the basis of our findings, we suggest readjusting the spectrum of radiographic measurement values that should be recognized as normal. With the currently existing tight and short zone of normal parameters for impingement, more patients are likely to be classified as abnormal and may undergo additional imaging and treatment that may not be necessary.More research needs to be done to help to correlate static radiographs with a dynamic condition. We also believe that surgical decision-making in the diagnosis and management of femoroacetabular impingement in adolescents should not be based solely on radiographic parameters
